Punjab

Patiala

CC/15/123

Gurpreet Kaur - Complainant(s)

Versus

LIC of India - Opp.Party(s)

Sh Sanjay Khanna

23 Dec 2015

ORDER

DISTRICT CONSUMER DISPUTES REDRESSAL FORUM, PATIALA.

Complaint No. CC/15/123 of 11/06/2015

Decided on 23/12/2015

1. Gurpreet Kaur w/o JagjitSingh R/o Village Ghabdan, Tehsil & District Sangrur.

2. Lakhvir Kaur W/o Karamjeet Singh R/o Village Chunagra, Tehsil Patran, District Patiala.

….Complainants.

Versus

1. LIC of India, Branch, Samana,District Patiala through its Branch Manager.

2. LIC of Idia, Jeevan Prakash Building, Sector 17-B, Chandigarh, through Sr. Divisional Manager.

….Opposite parties.

 

Complaint under Sections 11 to 14 of the

Consumer Protection Act.

 

QUORUM

Sh. D. R. Arora, President Smt. Neelam Gupta, Member

Smt. Sonia Bansal, Member

 

Present:

For Complainant : Sh. Naveen Trehan Advocate.

For Opposite parties : Sh. Manjit Singh Advocate.

 

ORDER

D. R. ARORA, PRESIDENT:

1. It is the case of the complainant that the deceased Smt Pal Kaur, their mother was the holder of the policy no.162186452 got from the OPs valid for the period 28/1/2002 to 28/1/2018 for a sum insured of Rs.one lac besides the additional benefit of Rs.one lac on account of accidental benefits. The complainant Smt. Gurpreet Kaur was the nominee under the policy.

2. On 18/6/2013, the insured Smt. Pal Kaur died in a road side accident having fallen from the motor cycle and sustained serious insuries on her head and body. She waas got admitted in the PGI Chandigarh where she was operated upon. Later on she was got admitted in Dr. Arun Bhandari's Brain, Spine and Trauma Centre, Patiala and subsequently she was got admitted in A. P. Health Care & Trauma centre, Bhadson Road, Patiala where she scummbed to the injuries on 17/08/2013. DDR no.43 dt.19/06/2013 was lodged with P. S. Bhawanigarh.

3. Complainant Gurpreet Kaur lodged the claim with the OP along with the documents as demanded by OP no.1. OPs disbursed a sum of Rs.1,55,800/- only in favour of complainant on 01/01/2014, which was the payment of the sum insured + vasted bonus but the OPs failed to disburse the accidental benefit of Rs.One Lac.

4. Complainant Gurpreet Kaur visited the office of OP no.1 and requested for the disbursement of the accidental benefit but OP no.1 disclosed that the matter was under consideration. The complainants visited the OPs a number of times but they failed to settle the accidental benefit and rather went on putting the matter off under one or the other pretext, which is said to be deficiency in service on the part of the OPs which resulted into harassment and mental agony experienced by the complainants. Accordingly the complainants brought this complaint against the Ops u/s 12 of the Consumer Protection Act 1986 ( for short the Act) for a direction to the OPs to pay a sum of Rs. One Lac on account of the accidental death benefit with interest @ 18 % per annum from the date of the death; to pay Rs.50,000/- by way of compensation for harassment and mental agony experienced by the complainants and further to pay a sum of Rs.11,000/- towards the litigation expenses.

5. On appearance the ops filed their written version. It is admitted by the OPs that deceased Pal Kaur mother of the complainants had obtained the life assurance policy no.162186452 from OP no.1 on 28/01/2002 and the maturity date of the same was 28/01/2018. It is also admitted that sum assured under the policy was Rs. One lac. Similarly it is admitted by the OPs that in case of accidental death of the life assured under the endowment insurance accidental benefit shall be paid.

6. It is denied by the OPs that deceased life assured had met with a road side accident having fallen from the motor cycle and that she sustained injuries on her head and body and she was got admitted in the PGI where she was operated. OP has also denied that she was admitted in Arun Bhandari's Brain, Spine and Trauma Centre and then she was got admitted in A. P. Health Care and Trauma Centre, Bhadson Road, Patiala where she scummbed to the injuries on 17/08/2013. The complainants have not supplied the documents regarding the lodging of the FIR, post mortem report and PIR duly attested by the issuing authority and full treatment record from the date of the accident till death. Since the said documents were not submitted along with the claim to OP no.1, the claim for additional benefit was not considered. Complainant Gurpreet Kaur submitted the claim along with the death certificate by writing a letter on 30/12/2013 without disclosing that injuries were sustained in an accident. Since the complainants have not furnished the requisite documents to consider the accidental claim, the accidental benefit was not paid. However, the complainant Gurpreet Kaur was directed to produce the record but she failed to produce the same. A sum of Rs. 1,55,800/- was paid to the complainants having credited the same in the account of the complainant. The complaint filed by the complainants is said to be premature as they were required to submit the necessary documents as referred above. Ultimately, it was prayed to dismiss the complaint.

7. In support of their complaint, the complainants produced in evidence Ex.CA, the sworn affidavit of Gurpreet Kaur along with documents Ex.C-1 to Ex.C-18 and their counsel closed the evidence. On the other hand on behalf of the OPs, their counsel tendered in evidence Ex.OPA, the sworn affidavit of Smt. Nisha Sarwal of the OPs along with documents Ex.OP-1 to Ex. OP-4 and closed the evidence.

8. OPs filed the written arguments. We have examined the same, heard the ld. counsel for the parties and gone through the evidence on record.

9. During the course of the arguments, ld. counsel for the OPs suffered the statement that OPs are very much ready to grant the accidental benefits of the Insurance policy in question to the complainants and that the complaint may be disposed off accordingly.

10. Here it is important to note that under similar circumstances, OP no.2 had, in complaint no.594 of 2014 brought by the complainant Lakhvir Kaur against OP no.2 as also LIC of India, Branch Railway Road Sangrur, in which the complainant had sought the accidental benefit under the policy no. 162541532 on account of the death of her mother Smt. Pal Kaur, suffered the statement ( Copy Ex.C-5) that they had settled the claim of the complainant and made the payment of accidental benefit and accordingly the complaint was disposed off vide order dt. 06/01/2015 Ex.C-4. In our complaint the complainants, aforesaid Lakhvir Kaur as also her sister Gurpreet Kaur, are the legal heirs of the deceased Smt. Pal Kaur. Therefore, in the light of the statement suffered by the counsel for the OPs, we accept the complaint and direct the OPs to release the accidental benefits in respect of policy no. 162186452 in favour of the complainants with interest @ 9% from the date they paid life assurance benefit i.e. w.e.f. 01/01/2014 till final payment. In view of the facts and circumstances of the case, the complaint is accepted with costs assessed at Rs.7500/-. The order be complied by the OPs within one month on receipt of the certified copy of the order.

Pronounced

Dated:23/12/2015.

 

Sonia Bansal Neelam Gupta D. R. Arora

Member Member President